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DocuSign Envelope ID:913F749B-B9E8-4103-AF9D-A4296D01069E t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> b.) Program Budget Detail <br /> What is the cost to deliver your project/program? List each project/program element in the table below, <br /> including the cost of each element, the quantity and unit of measure, and the subtotal for each element. <br /> Where necessary, allocate costs to the use of shared space, vehicles or equipment. <br /> Example Program: Credit Counseling Class <br /> Cost Elements Cost(5) Quantity/Unit of Measure Subtotal ($) <br /> Credit Counseling Teacher–in class $25 96 hours(8 hrshnth x 12 months) $2,400 <br /> Credit Counseling Teacher—class prep $25 46 hours(4hrsimth x 12 mths) $1,200 <br /> Credit Counselor--one-on-one $20 120 hours(10 hrslmth x12 mths $2,400 <br /> Materials $25 120 course packets/credit reports $3,000 <br /> Total $9,000 <br /> Complete the table below for the project/program for which you are requesting funds. <br /> Attach additional rows/pages, as needed. <br /> Program: _Young Warriors Program <br /> Cost Elements Cost($) Quantity/Unit of measure Subtotal (5) <br /> instruction $300/child Per child X 33 kids $9,900 <br /> Case Management $245/child Per child X 33 kids $8,100 <br /> Utilities& Rent $458/child % Cost X 33 kids $15,100 <br /> Su plies &Equipment $75/child $75/child uniform X 33 kids $2,500 <br /> Total $35,600 <br /> C.) Cost per Unit <br /> Actual 2014-15 Estimated 2015-16 Projected 201 6-17 <br /> Total Cost of Program 29,600 30,689 35,600 <br /> Total # of Units 28 30 33 <br /> Cost Per Unit 1,057 1,022 1,078 <br /> This Cost Per Unit must reflect the total program budget and the total number of <br /> program beneficiaries (households or persons) in this application and must be <br /> consistent with report submittals from previous years (if applicable). <br /> Main Application 1/25/2016 10:16:09 AM Page 18 of 20 <br />